A Metaphor Analysis of Patients' With Chronic Conditions Experiences With Holistic Nurse Coaching.

The purpose of this study was to examine metaphors used by patients with chronic conditions to describe their experience with holistic nurse coaching. A secondary analysis was conducted using Metaphor Identification Procedure to analyze the corpus of 112 pages of typed transcription. Five metaphors emerged: (1) taking personal power back like acquiring a new toolbox; (2) seeing health challenges from different angles like a duck pond race; (3) shifting perception of a chronic condition like a spider turned into a friend; (4) engaging in self-care like caring for a favorite plant; and (5) choosing to focus on the positive like a collage that changed from dark to light. Specific interventions can be developed to address each of these metaphors to help patients live well with chronic conditions.

Trends in Contemporary Holistic Nursing Research: 2010-2015.

PURPOSE: The purpose of this study was to describe and summarize the characteristics of contemporary holistic nursing research (HNR) published nationally. DESIGN: A descriptive research design was used for this study. METHOD: Data for this study came from a consecutive sample of 579 studies published in six journals determined as most consistent with the scope of holistic nursing from 2010 to 2015. The Johns Hopkins level of evidence was used to identify evidence generated, and two criteria-power analysis for quantitative research and trustworthiness for qualitative research-were used to describe overall quality of HNR. FINDINGS: Of the studies, 275 were considered HNR and included in the analysis. Caring, energy therapies, knowledge and attitudes, and spirituality were the most common foci, and caring/healing, symptom management, quality of life, and depression were the outcomes most often examined. Of the studies, 56% were quantitative, 39% qualitative, and 5% mixed-methods designs. Only 32% of studies were funded. Level III evidence (nonexperimental, qualitative) was the most common level of evidence generated. CONCLUSIONS: Findings from this study suggest ways in which holistic nurse researchers can strengthen study designs and thus improve the quality of scientific evidence available for application into practice and improve health outcomes.

Pilot Testing of the NURSE Stress Management Intervention.

Student nurses experience significant stress during their education, which may contribute to illness and alterations in health, poor academic performance, and program attrition. The aim of this pilot study was to evaluate the feasibility and potential efficacy of an innovative stress management program in two baccalaureate nursing programs in Connecticut, named NURSE (Nurture nurse, Use resources, foster Resilience, Stress and Environment management), that assists nursing students to develop stress management plans. An explanatory sequential mixed-methods design was used to evaluate the effects of the intervention with 40 junior nursing students. Results from this study provide evidence that the NURSE intervention is highly feasible, and support further testing to examine the effect of the intervention in improving stress management in nursing students.

Finding the right words: the experience of new nurses after ELNEC education integration into a BSN curriculum.

INTRODUCTION: Palliative care is an important aspect of nursing when comfort and quality of life are the patient goals. Literature about practicing nurses, whether new graduates or more experienced, suggests they feel unprepared for end-of-life care. The End-of-Life Nursing Education Consortium (ELNEC) developed a comprehensive program of teaching care of the dying to nurses and nursing students throughout the United States. PURPOSE OF STUDY: Researchers conducted this phenomenological study to explore the lived experiences of recent graduates who received ELNEC education content in their nursing programs and who cared for a dying patient within the first year of clinical practice. METHODOLOGY: Using open-ended semi-structured questions, researchers conducted taped interviews with a convenience sample of 12 recent graduates to capture the nurses' narratives. The stories of these new nurses highlighted issues they encountered and interventions they implemented to address these issues. Colaizzi's method of content analysis was employed. FINDINGS: Final themes that emerged were facilitating a good death, realizing intrinsic rewards, learning through impressionable experiences, and maintaining balance. CONCLUSIONS: This research revealed the experiences of new nurses who received ELNEC education in their nursing programs and who cared for dying patients within the first year of practice, highlighting issues they encountered and interventions they implemented to address these issues. Stories from these participants' lived experiences offer helpful insight into the challenges of implementing EOL care in clinical practice as they supported patients and families through the dying process.

Advanced practice nursing students' knowledge, self-efficacy, and attitudes related to depression in older adults: teaching holistic depression care.

The aim of this study was to examine the knowledge, attitudes, and self-efficacy of advanced practice nursing students toward depression in older adults. Findings suggest that advanced practice nursing students are interested in caring for the whole person and desired more information on the physical and emotional-spiritual needs of older patients with depression. Suggestions for holistic nursing depression care education are presented.

The influence of a spirituality-based intervention on quality of life, depression, and anxiety in community-dwelling adults with cardiovascular disease: a pilot study.

PURPOSE AND DESIGN: The specific aims of this pre-experimental pilot study were to determine the feasibility and preliminary efficacy of an individualized spirituality-based intervention on health-related outcomes (quality-of-life [QOL], depression, and anxiety) in community-dwelling patients with cardiovascular disease (CVD). METHODS: Self-reported QOL, depression, and anxiety data were provided by cardiac patients recruited from three community-based organizations, ( N = 27) at baseline and one month later. The Spirituality Scale developed by the principal investigator assessed study participants' level of spirituality and scoring on the subscales activated one or more of three spirituality-based interventions. Repeated measures analysis of variance was used to evaluate temporal changes. FINDINGS: Patients who participated in the 1-month intervention demonstrated a significant modest increase in overall QOL. There was a trend toward lower depression scores but this was not significant. No significant changes were seen in anxiety scores. Content analysis of patients' perceptions of feasibility supports the acceptability of the intervention. CONCLUSION: Results from this small pilot study provide preliminary evidence that the individualized spirituality-based intervention used in this study holds promise as an addition to traditional cardiac care and has the potential to improve QOL in community-dwelling adults with CVD.

Primary Stroke Center education for nurses: improving core measures.

Primary Stroke Center designation by the Joint Commission distinguishes those healthcare organizations with exemplary stroke prevention and management. However, meeting the Joint Commission's high-level excellence standards is challenging. This article provides nurse leaders with a stroke education template, based on Donabedian's quality model, which meets Primary Stroke Center nurse education requirements. The authors describe the structure, process, and outcomes of a stroke education program for nurses, recognized as Best-in-Practice in Connecticut, successfully implemented in a community hospital.

Ecospirituality: the experience of environmental meditation in patients with cardiovascular disease.

Ecospirituality provides a framework for exploring the spiritual dimension of person and environment and the dynamic interplay between this sacred dyad and human health. The aim of this phenomenological study was to explore and describe the experience of environmental meditation by using a new, spirituality-based meditation intervention that focused on ecospirituality with patients with cardiovascular disease. A convenience sample of 6 women and 2 men with ages ranging from 42 to 64 years and a mean age of 57 years (SD = 8.33 years) participated in the study. From the 8 journals and the researchers' field notebooks, 85 significant phrases or sentences were extracted, transposed into formulated meanings, and later collapsed into 4 theme clusters: Entering a New Time Zone, Environmental Reawakening, Finding a New Rhythm, and Becoming a Healing Environment. The findings of this study provide beginning support for holistic nurses and other healthcare professionals to integrate the use of ecospirituality meditation into their care of patients with cardiovascular disease and the groundwork for further exploration of the spiritual dimension of person and environment.

Blessings: the influence of a spirituality-based intervention on psychospiritual outcomes in a cardiac population.

Cardiovascular disease affects an individual's body, mind, and spirit. The multidimensional impact of heart disease requires holistic care that includes the spiritual dimension for patients to achieve optimal healing and recovery. This pretest, posttest repeated-measures quasi-experimental study sought to examine the influence of a spiritual intervention on psychospiritual outcomes in a cardiac population.

The influence of end-of-life education on attitudes of nursing students.

Palliative care is an important aspect of nursing when comfort and quality of life are the patient goals. The End-of-Life Nursing Education Consortium (ELNEC) developed a comprehensive program of teaching care of the dying to nurses and nursing students. This pretest-posttest study evaluated the influence of the integration of the ELNEC curriculum into a baccalaureate nursing program on students' attitudes toward care of the dying. The Frommelt Attitudes toward Care of the Dying Scale for nurses (FATCOD) was administered to traditional and accelerated baccalaureate students before and after exposure to a nursing curriculum that integrated essential ELNEC elements. Multiple regression analyses indicated that no previous experience with death and an age of 18-22 accounted for the most variance in attitude change. The findings suggest that integrating the ELNEC curriculum throughout a baccalaureate program positively affects the attitudes of nursing students toward the care of patients who are dying.

Discourse analysis of nurse-patient communication in a hospital setting: implications for staff development.

This ethnographic study examined the symmetry (active listening)/asymmetry (dominance) of nurse-patient communication. A convenience sample of 20 gendered nurse-patient pairs from two community hospitals participated. Eleven discourse modes emerged from taped conversations between nurses and patients. In many nurse-patient interactions, nurses demonstrated symmetry; however, symmetry and asymmetry changed throughout the conversation. Nurses often missed cues that patients needed someone to listen to their concerns. Staff development implications include teaching strategies that increase symmetrical nurse-patient communication.